Abstract

Context: The occupied Palestinian territories (oPt) consists of the non-contiguous West Bank including East Jerusalem and the Gaza Strip. It is densely populated within these confines, and has a unique socio-economic context characterized by political and economic tensions. Around 2.2 million Palestinians are displaced and living in the ten UNRWA refugee camps in Jordan. Palestinian communities are exposed to a double burden of disease caused by the severe economic, social and health consequences of Israeli occupation and resultant displacement. Exposure to political violence, economic hardship, fragmentation of Palestinian families, unemployment, trauma and community stress underpin a reported rise in drug abuse.Method:A qualitative study using focus groups (n=3) with a convenience sample of health care and educational professionals was conducted in two UNRWA camps (Al-Zarka, Al-Wehdat) in Jordan. Guided discussions explored the experiences of these professionals in working with Palestinian families and children affected by substance/drug use and drug use disorder in the home. Data were analysed using thematic analysis (TA).Results: Five themes emerged from the TA. These were: 1)Access to drugs was perceived to be relatively easy in the camps; 2) Attitudes towards drugs appear to have desensitised, yet stigma persists; 3) Families of drug users are affected by fear, social and economic poverty, with significant physical and psychological cost to children; 4) Causes of substance/drug use in Palestinian communities living in Jordanian UNRWA camps is multifactorial; 5) Solutions are multi-faceted and indicative of the need for prevention and support for those at risk, and affected.Conclusions: Threats to UNRWA from the current political climate and the reducing investment in services may exacerbate this public health and security issue. For an evidence based approach to have credibility in the camp communities, there is a need for accurate, factual information, along with robust epidemiological data, relating to the extent, characteristics and harms associated with drug use.